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Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Eloisa Colín-Ramírez, MSc: Instituto Nacional.

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Presentation on theme: "Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Eloisa Colín-Ramírez, MSc: Instituto Nacional."— Presentation transcript:

1 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Eloisa Colín-Ramírez, MSc: Instituto Nacional de Ciencias Médicas y Nutrición SZ (INCMNSZ) Asociación Mexicana para la Prevención de Insuficiencia Cardiaca A.C. (AMEPPIC) Lilia Castillo-Martínez, MSc.: INCMNSZ, AMEPPIC Arturo Orea-Tejeda, MD: INCMNSZ, AMEPPIC Antonio R Villa Romero, MD: INCMNSZ Arely Vergara Castañeda, MSc.: AMEPPIC Enrique Asensio Lafuente, MD: INCMNSZ JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June).

2 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Background Elevated blood pressure at a young age predicts blood pressure elevation later in life and is associated with being overweight at all ages. There are other factors related to hypertension in childhood. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June).

3 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Objective To determine the anthropometric, physical activity and dietary factors associated with both systolic and diastolic hypertension in a group of Mexican school-aged children. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June).

4 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Design In this cross-sectional descriptive study, blood pressure, anthropometric, physical activity and dietary intake (assessed with a multiple-pass 24-hour dietary recall) evaluations were performed on school-aged children from September, 2005 to July, 2006. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June).

5 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Subjects Children aged 8-10 years (626 males and 613 females) from a convenience sample of 23 public schools of low socioeconomic status in Mexico City were included. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 5

6 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Statistical Analysis Descriptive statistics, X2 tests, analysis of variance, post hoc analysis with Bonferroni method, and logistic regression analysis were performed. Continuous variables are presented as mean ± standard deviation, categorical variables as percentages, and the association measures as adjusted odds ratios (OR). A p-value <0.05 was considered statistically significant, and 95% confidence intervals (CI95%) were calculated for adjusted OR. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 6

7 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results Dietary assessment showed that both boys and girls had a low fiber intake (<25 g/d) as well as an excessive mean consumption of total and saturated fat (>35.0% and >10.0% of the daily energy, respectively). Based on the total cohort, 3.6% had systolic hypertension, 14.2% diastolic hypertension, and 22.8% mixed hypertension. The higher values of weight, body mass index (BMI), waist circumference, and prevalence of overweight and obesity, were more common among children with mixed hypertension, followed by children in the systolic group. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 7

8 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results Subjects with diastolic and mixed hypertension reported increased intake of dietary total fat (37.7% and 38.2% of the daily energy intake, respectively). Adjusted OR=1.06 (CI95% ) for systolic hypertension per increase of 1 cm in waist diameter Total fat intake >35.0% of the daily energy (kcal) showed an adjusted OR=2.61 (CI95% ) for diastolic hypertension. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 8

9 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Anthropometric and blood pressure variables according to gender for Mexican children aged 8-10 years Variable Boys (n=626) Girls (n=613) Age (years) Weight (kg) Height (cm) Body mass index (kg/m2) Waist circumference (cm) Systolic blood pressure (mmHg) Diastolic blood pressure (mmHg) JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 9

10 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Dietary intake variables assessed with a single 24-hour recall according to gender for Mexican children aged 8-10 years Variable Boys (n=626) Girls (n=613) Energy (Kcal/d) Fiber (g/d) Carbohydrate (g/d) Energy from carbohydrate (%) Protein (g/d) Energy from protein (%) Total fat (g/d) Energy from total fat (%) Saturated fat (g/d) Energy from saturated fat (%) Polyunsaturated fat (g/d) Energy from polyunsaturated fat (%) Monounsaturated fat (g/d) Energy from monounsaturated fat (%) Cholesterol (mg/d) Sodium (mg/d)a Calcium (mg/d) Magnesium (mg/d) Potassium (mg/d) JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). a.Excluding salt used in cooking 10

11 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Anthropometric and blood pressure variables according to type of hypertension for Mexican children aged 8-10 years Variable Normal systolic and diastolic BP n=606 Systolic hypertension n=45 Diastolic hypertension n=176 Mixed hypertension n=283 p valueab Gender [Male (%)] 48.7 44.4 42 54.1 0.080 Age (years) d e def f 0.000***d 0.046*e 0.016*f Weight (kg) gdh gi df hif 0.000***gdhif Body mass indexc (kg/m2) gdh gei def hif 0.000***gdhf 0.015*e 0.001**i Overweight (%) 16.2 31.1 27.8 36.0 0.000*** Obesity (%) 1.8 24.4 7.4 36.7 Waist circumference (cm) gdh gi df hif Systolic blood pressure (mmHg) gdh gei def hif 0.000***gdheif Diastolic blood pressure (mmHg) dh ei def hif 0.000***dheif a.After post hoc analysis using the Bonferroni method for variables with p<0.05 in analysis of variance for continuous variables. b.Based on Pearson’s Chi2 test for categorical variables. c.Mean difference based on analysis of variance. d.Difference between normal and diastolic hypertension groups. e.Difference between systolic and diastolic hypertension groups. f.Difference between diastolic and mixed hypertension groups. g.Difference between normal and systolic hypertension groups. h.Difference between normal and mixed hypertension groups i.Difference between systolic and mixed hypertension groups. *Statistically significant difference at p< **Statistically significant difference at p<0.01 ***Statistically significant difference at p<0.001 JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 11

12 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Dietary intake variables according to type of hypertension for Mexican children aged 8-10 years Variable Normal systolic and diastolic BP n=606 Systolic hypertension n=45 Diastolic hypertension n=176 Mixed hypertension n=283 p valuea Fiberb (g) Energyb (Kcal/d) From carbohydrateb (%) From proteinb (%) From total fatb (%) From saturated fatb (%) From polyunsatyrated fatb (%) From monounsaturated fatb (%) c c 0.04*c Cholesterolb (mg) Sodiumbd (mg) e f ef 0.03*e 0.04*f Calcium (mg) Magnesium (mg) Potassium (mg) a.After post hoc analysis using the Bonferroni method for variables with p<0.05 in analysis of variance. b.Mean difference based on analysis of variance. c.Difference between systolic and mixed hypertension groups. d.Excluding salt used in cooking. e.Difference between normal and mixed hypertension groups. f.Difference between diastolic and mixed hypertension groups. *Statistically significant difference at p<0.05 JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 12

13 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Logistic regression analysis of the association of systolic hypertension with overweight status and diet for Mexican children aged 8-10 years Ba S.E.b Wald dfc ORd 95.0% C.I.e for OR Lower Upper Age (years) -0.55 0.25 4.82 1 0.58* 0.35 0.94 Gender Male:1 Female: 0 0.10 0.31 1.10 0.60 2.02 Diastolic blood pressure (mm Hg) 0.13 0.02 63.98 1.14*** 1.17 Waist circumference (cm) 0.05 5.04 1.06* 1.01 1.11 a.Beta coefficient b.Standard error c.Degree of freedom d.Odds ratio for the association with the presence of systolic hypertension. e.Confidence interval *Statistically significant difference at p<0.05 ***Statistically significant difference at p<0.001 JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 13

14 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Logistic regression analysis of the association of systolic hypertension with overweight status and diet for Mexican children aged 8-10 years (cont’d) Ba S.E.b Wald dfc ORd 95.0% C.I.e for OR Overweight Overweight and/or obesity:1 Normal weight: 0 0.39 0.43 0.86 1 1.48 0.64 3.41 Energy intake (Kcal/d) 0.00 0.83 1.00 Total fat intake >35% of daily energy: 1 <35% of daily energy: 0 -0.50 0.41 1.52 0.61 0.27 1.35 Saturated fat (mg/d) -0.03 0.06 0.21 0.97 1.10 Monounsaturated fat (mg/d) 0.04 1.04 0.93 1.16 Sodium (mg/d) 1.45 Constant -10.35 2.70 14.76 a.Beta coefficient b.Standard error c.Degree of freedom d.Odds ratio for the association with the presence of systolic hypertension. e.Confidence interval *Statistically significant difference at p<0.05 ***Statistically significant difference at p<0.001 JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 14

15 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Logistic regression analysis of the association of diastolic hypertension with overweight status and diet for Mexican children aged 8-10 years Ba S.E.b Wald dfc ORd 95.0% C.I.e for OR Lower Upper Age (years) 0.32 0.22 2.14 1 1.38 0.90 2.11 Gender Male:1 Female: 0 0.14 0.27 1.15 0.68 1.96 Systolic blood pressure (mm Hg) 0.13 0.02 80.78 1.14*** 1.11 1.18 Waist circumference (cm) -0.02 0.43 0.99 0.94 1.03 Overweight Overweight and/or obesity:1 Normal weight: 0 0.41 0.40 1.04 1.51 0.69 3.31 Energy (Kcal/d) 0.00 1.24 1.00 a. Beta coefficient b.Standard error c.Degree of freedom d.Odds ratio for the association with the presence of systolic hypertension. e.Confidence interval *Statistically significant difference at p<0.05 ***Statistically significant difference at p<0.001 JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 15

16 Monounsaturated fat (mg/d)
Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Logistic regression analysis of the association of diastolic hypertension with overweight status and diet for Mexican children aged 8-10 years (cont’d) Ba S.E.b Wald dfc ORd 95.0% C.I.e for OR Total fat intake >35% of daily energy: 1 <35% of daily energy: 0 0.96 0.37 6.86 1 2.61** 1.27 5.36 Saturated fat (mg/d) -0.05 0.06 0.78 0.95 0.85 1.06 Monounsaturated fat (mg/d) 0.02 0.05 0.13 1.02 0.92 1.12 Sodium (mg/d) 0.00 0.20 1.00 Constant -16.57 2.65 38.98 a.Beta coefficient b.Standard error c.Degree of freedom d.Odds ratio for the association with the presence of systolic hypertension. e.Confidence interval *Statistically significant difference at p<0.05 ***Statistically significant difference at p<0.001 JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 16

17 Results: Prevalence of overweight and obesity
Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Prevalence of overweight and obesity in Mexican children aged 8-10 years JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 17

18 Results: Prevalence of hypertension in Mexican
Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Results: Prevalence of hypertension in Mexican children aged 8-10 years SH=Systolic hypertension, DH=Diastolic hypertension, SDH=Systolic and diastolic hypertension. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 18

19 Waist circumference and fat intake are associated with high blood pressure in Mexican children aged 8-10 years Conclusions In a sample of Mexican children of low socioeconomic status, the prevalence of hypertension was high. Waist circumference was the main factor associated with systolic hypertension, and higher intake of total fat was related to diastolic hypertension. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Colín-Ramírez E, et al. J Am Diet Assoc. 2009; 109 (June). 19

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